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目的探讨内窥镜立体定向活检术的准确性及其在颅内病变诊断中的临床价值。方法回顾性总结2009年1月至2013年6月间昆明医科大学第一附属医院神经外二科收住院并行内窥镜立体定向活检术的16例病例,患者年龄6~59岁(平均38.8岁),其中男性患者10例,女性患者6例;病变位于额叶5例,颞叶2例,顶叶2例,枕叶1例,基底节区1例,多发病变5例。结果病理诊断阳性率87.5%(14例),其中炎性肉芽肿4例,星形细胞瘤WHOⅠ-Ⅱ级3例,星形细胞瘤WHOⅡ级2例,毛细胞星形细胞瘤WHOⅠ级1例,混合型少突-星形细胞瘤WHOⅡ级1例,多形性胶质母细胞瘤WHOⅣ级1例,弥漫性大B细胞淋巴瘤1例,颅内肉芽肿性动脉炎1例,阴性2例。无术后昏迷、偏瘫、感染、颅内出血等严重并发症。结论内窥镜立体定向活检术是颅内病变诊断的重要方法之一,定位精确、创伤小、安全可靠、有效减少并发症的发生、值得推广。
Objective To investigate the accuracy of endoscopic stereotactic biopsy and its clinical value in the diagnosis of intracranial lesions. Methods From January 2009 to June 2013, 16 cases of endoscopic stereotactic biopsy in the Second Affiliated Hospital of Kunming Medical University from January 2009 to June 2013 were retrospectively reviewed. The patients were 6 to 59 years old (average 38.8 years old ), Including 10 males and 6 females. The lesion was located in 5 cases of frontal lobe, 2 cases of temporal lobe, 2 cases of parietal lobe, 1 case of occipital lobe, 1 case of basal ganglia and 5 cases of multiple lesions. Results The positive rate of pathological diagnosis was 87.5% (14 cases), including 4 cases of inflammatory granuloma, 3 cases of WHOⅠ-Ⅱ grade astrocytoma, 2 cases of WHO Ⅱ grade astrocytoma, 1 case of WHOⅠ grade of astrocytoma of hair cells , Mixed oligodendrocytes - astrocytoma WHO grade Ⅱ 1 case, glioblastoma multiforme WHO Ⅳ grade 1 case, diffuse large B cell lymphoma in 1 case, intracranial granulomatous arteritis in 1 case, negative 2 example. No postoperative coma, hemiplegia, infection, intracranial hemorrhage and other serious complications. Conclusion Stereotactic endoscopic biopsy is one of the important methods for the diagnosis of intracranial lesions. Precise positioning, small trauma, safe and reliable, and effective in reducing the incidence of complications are worth popularizing.